Acute Respiratory Failure, Mechanical Ventilation Complication, Ventilator-Induced Lung Injury, Weaning Failure
Conditions
Keywords
Electrical Impedance tomography, Weaning trial, Acute respiratory failure, Lung monitoring
Brief summary
The goal of this physiological cross-over clinical trial is to evaluate the effect of different clinically used weaning trials on regional mechanical ventilation in a population of patients undergoing weaning from mechanical ventilation for acute respiratory failure. The main question\[s\] it aims to answer are: * to evaluate which weaning trial is associated to a better regional ventilation distribution * to evaluate which weaning trial can be comparable to ventilation distribution after extubation Participants will undergo 3 clinically used weaning trials in a random order (cross-over trial). Researchers will compare the different steps to see if regional ventilation distribution is different among the different trial .
Interventions
DIAGNOSTIC_TESTWeaning trial - Low support, high Positive end-expiratory pressure
The researcher will evaluate the readiness to be weaned of the patient using a weaning trial with low pressure support ventilation and a positive end expiratory pressure of 5 cmH2O
DIAGNOSTIC_TESTWeaning trial - Low support, zero positive end-expiratory pressure
The researcher will evaluate the readiness to be weaned of the patient using a weaning trial with low pressure support ventilation and a positive end expiratory pressure of 0 cmH2O
DIAGNOSTIC_TESTWeaning trial - Zero support, zero positive end-expiratory pressure
The researcher will evaluate the readiness to be weaned of the patient using a weaning trial with 0 pressure support ventilation and a positive end expiratory pressure of 0 cmH2O
Sponsors
University of Milan
Università degli Studi di Ferrara
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
DIAGNOSTIC
Masking
DOUBLE (Subject, Caregiver)
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Age \> 18 and \< 70 years * Ready to be weaned from mechanical ventilation according to clinical criteria
Exclusion criteria
* Age \< 18 years or \> 70 years * Presence of chest drains * Presence of pacemaker/impantable cardiac device; * diagnosis of Pneumothorax, or pneumomediastinum * Diagnois of neuromuscular diseases * Use of neuromuscular blockers in the 48 hours before screening; * Body mass index \> 35 kg/m2 * Refusal to participate of the patient/next of kin
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Regional Ventilation distribution using Electrical Impedance Tomography | 2 hours | The researchers will evaluate differences in ventilation distribution pattern among the different weaning trials using Electrical Impedance Tomography and focusing on: * Regional ventilation distribution * Regional inhomogeneity * Regional compliance distribution * Center of Ventilation * Silent Spaces |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Differences in Regional Ventilation distribution using Electrical Impedance Tomography between weaning trials and post-extubation phase | 48 hours | The researchers will evaluate differences in ventilation distribution pattern among the different weaning trials and the post-extubation phase using Electrical Impedance Tomography and focusing on: * Regional ventilation distribution * Regional inhomogeneity * Regional compliance distribution * Center of Ventilation * Silent Spaces |
Countries
Italy
Outcome results
None listed